What is exactly muscle tightening during a tummy tuck?

During pregnancy, the circulating maternal hormones allow some softening of the Mom's less stretchable tissues. This in turn makes room for the baby to grow. Two types of tissue that are particularly in need of more stretching ability during pregnancy are ligaments and fascia. Both are generally non-elastic.  The abdominant muscles, your 6-pack, are held together firmly down the middle by fascia. There is no gap. This changes in pregnancy and may or may not return to its pre-pregnancy state after delivery. During an abdominoplasty, what is referred to as muscle tightening, is actually the sewing closed of the gap between the two abdominal muscle columns. It is reapproximation of the abs, rather than actual tightening of the abs. The net result however, is a tighter stomach, which you no longer have to suck in, and improved waistline. Dr. B.

Thank you for your question.  Due to pregnancy or weight gain the two muscles that comprise the "6-pack" become stretched and the space between them grows.  Sometimes after weight loss or delivery the muscles are unable to shrink back to sit next to one another and a space remains.  The muscle repair during a tummy tuck helps to tighten these muscles back to one another to create a flatter appearance.  Hope that this helps.

After childbirth, women’s bodies might experience certain changes: some of these can be very subtle, but others can change their physiognomy completely. Women love their babies, but some also don’t like the changes to their bodies that come with pregnancy. Even more, they want to improve their bodies, so they are fitter than they were before, because they want their children to have healthy and beautiful mums.

Dr Hoyos designed two main procedures to fulfil all these mothers’ wishes. For mild to moderate changes, when there is too much skin laxity or stretch marks, a ‘mommy HD4’ is the procedure of choice. This repairs the abdominal muscles that have been over-stretched by the pregnancy through a small incision (less than a C-section scar) and add body contouring to achieve definition. This will erase the stigmata of the post-delivery belly and give a youthful appearance.

In cases where there is too much skin laxity and/or stretch marks, an ‘HD4 tummy tuck’ is the procedure of choice. While a regular abdominoplasty stretches the skin while taking out the extra tissue and stretch marks, the HD4 tummy tuck adds a new belly button and definition: giving the impression of a renewed body, with an athletic appearance, but without the annoying stigmata of surgery. Under a bathing suit, nobody will notice a tummy tuck was performed.

A tummy tuck is a wonderful procedure to improve the contour of the abdomen permanently.  It consists of 3 basic steps:Skin removalFat removalMuscle tighteningThe muscle traditionally tightened is the rectus abdominis muscle.  The rectus abdominis muscle, also known as the "abdominals or abs," is a paired muscle running vertically on each side of the anterior wall of the abdomen. There are two parallel muscles, separated by a midline band of connective tissue called the linea alba. It extends from the pubic bone inferiorly, to the xiphoid process and costal cartilages of ribs V to VII superiorly.  It is a wide muscle, about the width of a man's tie and is one of 3 layers of muscles of the anterior abdominal wall.During pregnancy the rectus muscle is stretched.  Normally, the paired muscle is "kissing" in the midline, but with the increase in volume inside of the abdomen, the muscle separates and leaves a gap in the middle.  This is called a diastasis recti.  This gap can be quite wide and the only way to repair this defect is to surgically bring the muscles back together again with a very strong suture.  Exercise will not correct this separation.  Other factors that contribute to forming a diastasis recti are rapid weight gain and loss, surgery that transects or cuts the muscle (i.e. C-section, hysterectomy, weight loss surgery).  The repair of the diastasis is a major portion of a tummy tuck procedure and is the reason that a woman must be finished with child bearing before undergoing this procedure.  If a pregnancy would occur after a tummy tuck, the muscles would again be stretched out, but always in a different and unusual pattern that CANNOT be fixed with another procedure.  We, as surgeons want this procedure to be permanent one time operation!Good Luck!

Thank you for the question.

One of the steps of a tummy tuck procedure involves reapproximation (plication)  of the rectus muscles.  These muscles have spread apart during pregnancy and/or weight gain. Bringing them together again in the midline helps to “tighten” the abdominal wall as well as to narrow the waistline.

I use a two layered technique to reapproximate the rectus muscles. The first layer is comprised of interrupted “figure of 8” sutures;  a second layer involves a “running” suture line. Some judgment is required to re-approximating muscle's at the right tension (tight enough but not too tight). The tightening of the muscles extend from the lower border of the sternum (xiphoid  process)  to the pubic bone.

Occasionally, plication  of the external oblique muscles on each side may be helpful in achieving an improved abdominal wall contour.

I consider the abdominal wall muscle plication  a “anatomy restoring”  procedure; personally, I think the restored anatomy can only be helpful in improving core and back strength/integrity.

I hope this helps.